In this study, platelet function analysis was performed using the Multiplate(r) platelet analyser (Dynabyte, Munich, Germany), whole blood impedance aggregometer which was proved to be sensitive for all three classes of commonly applied platelet function inhibitors: COX inhibitors (aspirin(r)), ADP receptor antagonists (Clopidogrel, Prasugrel, Cangrelor) and IIb/IIIa antagonists (Reopro(r), tirofiban
Oral antiplatelet drugs, aspirin and clopidogrel (Plavix), are prescribed in combination with warfarin and enoxaparin to prevent secondary thrombosis, (6) while the intravenous platelet inhibitors eptifibatide (Integrelin), abciximab (Rheopro), and tirofiban
(Aggrastat) are used during PCI to maintain patency.
Inhibition of the platelet glycoprotein IIb/IIIa receptor with tirofiban
in unstable angina and non-Q wave myocardial infarction [erratum appears in N Engl J Med 1998;339:415].
Adding a high-dose (25 [micro]g/kg) bolus infusion of tirofiban
to standard drug therapy just before high-risk percutaneous coronary interventions cut the rate of ischemic complications in a preliminary (phase II) study.
(Aggrastat), rated B; crosses the placenta, but animal studies show no evidence of fetal harm.
4-6] It has recently been demonstrated by several in vitro studies that antagonists of GPIIb/IIIa (Abciximab, Tirofiban
, and Eptifibatide) are able to inhibit platelet aggregation induced by the serum of patients with HIT II.
The limitations of dual antiplatelet therapy with aspirin and clopidogrel have been further illustrated by the on-TIME-2 trial, in which patients undergoing primary PCI were randomised to additional prehospital tirofiban
or placebo (42).
All of these patients were also treated with aspirin, heparin, and tirofiban
In high-risk patients who aren't headed off for immediate catheterization, however, the new guidelines recommend only the small-molecule IIb / IIIa inhibitors eptifibatide and tirofiban
After 48 hours tirofiban
infusion, control coronary angiography was performed (Fig.